{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:03:09Z","timestamp":1791388989582,"version":"4.3.3"},"reference-count":38,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R50 CA274122"],"award-info":[{"award-number":["R50 CA274122"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001299","name":"Prevent Cancer Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001299","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008548","name":"Harvard T.H. Chan School of Public Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008548","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000043","name":"American Association for Cancer Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000043","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008732","name":"Uehara Memorial Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008732","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000048","name":"American Cancer Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000048","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["23K20052"],"award-info":[{"award-number":["23K20052"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008746","name":"National Cancer Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008746","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Military Med Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The global increase in the incidence of early-onset cancers (defined as cancers diagnosed at 20\u201349\u00a0years old) is a serious public health problem. We investigated 1) whether the incidence trend of early-onset cancers differs from that of later-onset cancers and 2) whether both the incidence and mortality of early-onset cancers have increased concurrently.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We utilized age-standardized incidence and mortality rates for early-onset and later-onset cancers diagnosed between 2000 and 2017 from the Cancer Incidence in Five Continents and World Health Organization (WHO) mortality databases. The national obesity prevalence among adults aged 20\u201349\u00a0years was obtained from the National Clinical Database. Using joinpoint regression models, we calculated average annual percentage changes (AAPCs) for cancer incidence and mortality by cancer types and countries. We additionally conducted human development index (HDI)-stratified analyses and assessed the correlation between the obesity prevalence in younger populations and early-onset cancer incidence by country. To investigate the more recent trend of early-onset cancer mortality, we extended our mortality analysis after 2017 for cancer types and countries with statistically significant positive AAPCs in both incidence and mortality of early-onset cancers between 2000 and 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our analysis showed that 10 early-onset cancer types (thyroid cancer, breast cancer, melanoma, uterine cancer, colorectal cancer, kidney cancer, cervical cancer, pancreatic cancer, multiple myeloma, Hodgkin lymphoma) in females and 7 early-onset cancer types (thyroid cancer, kidney cancer, testis cancer, prostate cancer, colorectal cancer, melanoma, leukemia) in males had statistically significant positive AAPCs in at least 10 countries. Among these, the following early-onset cancer types had significantly higher AAPCs than later-onset cancer types in females: colorectal cancer (6 countries; AAPC range: 1.8\u20133.8%), cervical cancer (6 countries; AAPC range: 1.2\u20133.3%), pancreatic cancer (5 countries; AAPC range: 2.3\u201313.0%), and multiple myeloma (5 countries; AAPC range: 3.1\u20139.8%); in males: prostate cancer (12 countries; AAPC range: 3.9\u201318.4%), colorectal cancer (8 countries; AAPC range: 1.8\u20133.2%), and kidney cancer (6 countries; AAPC range: 2.0\u20136.0%). We observed statistically significant positive AAPCs in both the incidence and mortality of the following early-onset cancer types: uterine cancer (5 countries) and colorectal cancer (3 countries in females and 5 countries in males). The steeper increases in early-onset cancers compared with later-onset cancers were mainly observed in the very high-HDI country group, including early-onset colorectal cancer (AAPC\u2009=\u20092.4%, 95% CI 2.1\u20132.6 in females; AAPC\u2009=\u20092.0%, 95% CI 1.7\u20132.4 in males) to later-onset colorectal cancer (AAPC = \u22120.1%, 95% CI \u22120.2 to 0 in females; AAPC = \u22120.2%, 95% CI \u22120.3 to 0 in males). We observed strong positive correlations between the increasing obesity prevalence and the rising incidence of early-onset obesity-related cancers in several countries, including Australia (7 cancer types), United Kingdom (7 cancer types), Canada (7 cancer types), Republic of Korea (7 cancer types), and USA (6 cancer types) in females and United Kingdom (7 cancer types), Canada (6 cancer types), Australia (5 cancer types), Sweden (5 cancer types), and Republic of Korea (4 cancer types) in males. Although we did not observe an apparent spike after 2017 in many countries, we observed continued increases in the mortality of certain cancer types, such as uterine cancer (Japan, Republic of Korea, United Kingdom, USA, and Ecuador) in females and colorectal cancer (Argentina, Canada, United Kingdom, and USA) in males.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The increase in many early-onset cancer types was significantly higher than that of later-onset cancers, and the incidence and mortality of certain early-onset cancer types (such as colorectal cancer) increased simultaneously. Our study highlights global differences in cancer incidence and mortality trends of early-onset and later-onset cancers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40779-025-00670-8","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T09:50:27Z","timestamp":1763113827000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Diverging global incidence trends of early-onset cancers: comparisons with incidence trends of later-onset cancers and mortality trends of early-onset cancers"],"prefix":"10.1016","volume":"12","author":[{"given":"Miyu","family":"Terashima","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kota","family":"Nakayama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sora","family":"Shirai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoko","family":"Ugai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hwa-Young","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruna","family":"Matsui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Mizuno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiori","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minkyo","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoko","family":"Sasamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ichiro","family":"Kawachi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward L.","family":"Giovannucci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0182-5269","authenticated-orcid":false,"given":"Tomotaka","family":"Ugai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"key":"670_CR1","doi-asserted-by":"publisher","first-page":"04205","DOI":"10.7189\/jogh.14.04205","volume":"14","author":"J Chen","year":"2024","unstructured":"Chen J, Dalerba P, Terry MB, Yang W. Global obesity epidemic and rising incidence of early-onset cancers. J Glob Health. 2024;14:04205.","journal-title":"J Glob Health"},{"issue":"1","key":"670_CR2","first-page":"7","volume":"75","author":"BW Corn","year":"2025","unstructured":"Corn BW, Feldman DB. Cancer statistics, 2025: a hinge moment for optimism to morph into hope?. CA Cancer J Clin. 2025;75(1):7\u20139.","journal-title":"CA Cancer J Clin"},{"issue":"1","key":"670_CR3","first-page":"10","volume":"75","author":"RL Siegel","year":"2025","unstructured":"Siegel RL, Kratzer TB, Giaquinto AN, Sung H, Jemal A. Cancer statistics, 2025. CA Cancer J Clin. 2025;75(1):10\u201345.","journal-title":"CA Cancer J Clin"},{"issue":"1","key":"670_CR4","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/S1470-2045(24)00600-4","volume":"26","author":"H Sung","year":"2025","unstructured":"Sung H, Siegel RL, Laversanne M, Jiang C, Morgan E, Zahwe M, et al. Colorectal cancer incidence trends in younger versus older adults: an analysis of population-based cancer registry data. Lancet Oncol. 2025;26(1):51\u201363.","journal-title":"Lancet Oncol"},{"issue":"10","key":"670_CR5","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1038\/s41571-022-00672-8","volume":"19","author":"T Ugai","year":"2022","unstructured":"Ugai T, Sasamoto N, Lee HY, Ando M, Song M, Tamimi RM, et al. Is early-onset cancer an emerging global epidemic? Current evidence and future implications. Nat Rev Clin Oncol. 2022;19(10):656\u201373.","journal-title":"Nat Rev Clin Oncol"},{"key":"670_CR6","doi-asserted-by":"publisher","DOI":"10.1136\/bmjonc-2023-000049","volume":"2","author":"J Zhao","year":"2023","unstructured":"Zhao J, Xu L, Sun J, Song M, Wang L, Yuan S, et al. The global trends in incidence, death, burden and risk factors of early-onset cancer from 1990 to 2019. BMJ Oncol. 2023;2:e000049.","journal-title":"BMJ Oncol"},{"issue":"6","key":"670_CR7","first-page":"443","volume":"70","author":"KD Miller","year":"2020","unstructured":"Miller KD, Fidler-Benaoudia M, Keegan TH, Hipp HS, Jemal A, Siegel RL. Cancer statistics for adolescents and young adults, 2020. CA Cancer J Clin. 2020;70(6):443\u201359.","journal-title":"CA Cancer J Clin"},{"issue":"17","key":"670_CR8","doi-asserted-by":"publisher","first-page":"2136","DOI":"10.1200\/JCO.2012.47.3173","volume":"31","author":"AW Smith","year":"2013","unstructured":"Smith AW, Bellizzi KM, Keegan TH, Zebrack B, Chen VW, Neale AV, et al. Health-related quality of life of adolescent and young adult patients with cancer in the United States: the adolescent and young adult health outcomes and patient experience study. J Clin Oncol. 2013;31(17):2136\u201345.","journal-title":"J Clin Oncol"},{"issue":"12","key":"670_CR9","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.1016\/j.annonc.2024.08.2336","volume":"35","author":"S Ogino","year":"2024","unstructured":"Ogino S, Ugai T. The global epidemic of early-onset cancer: nature, nurture, or both?. Ann Oncol. 2024;35(12):1071\u20133.","journal-title":"Ann Oncol"},{"issue":"1","key":"670_CR10","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1093\/jnci\/djae208","volume":"117","author":"Y Zhang","year":"2025","unstructured":"Zhang Y, Lindstrom S, Kraft P, Liu Y. Genetic risk, health-associated lifestyle, and risk of early-onset total cancer and breast cancer. J Natl Cancer Inst. 2025;117(1):40\u20138.","journal-title":"J Natl Cancer Inst"},{"issue":"10431","key":"670_CR11","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1016\/S0140-6736(23)02750-2","volume":"403","author":"O Santos","year":"2024","unstructured":"Santos O. Collaboration NCDRF Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. Lancet. 2024;403(10431):1027\u201350.","journal-title":"Lancet"},{"key":"670_CR12","unstructured":"Cancer IUA. Cancer Incidence in Five Continents: a technical report. International Union Against Cancer; 1966."},{"key":"670_CR13","unstructured":"United Nations Development Programme (UNDP). Human development indices and indicators: 2018 statistical update. Available at https:\/\/digitallibrary.un.org\/record\/3794311?ln=en&v=pdf"},{"issue":"3","key":"670_CR14","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1002\/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z","volume":"19","author":"HJ Kim","year":"2000","unstructured":"Kim HJ, Fay MP, Feuer EJ, Midthune DN. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med. 2000;19(3):335\u201351.","journal-title":"Stat Med"},{"issue":"16","key":"670_CR15","doi-asserted-by":"publisher","first-page":"3102","DOI":"10.1002\/sim.9407","volume":"41","author":"HJ Kim","year":"2022","unstructured":"Kim HJ, Chen HS, Byrne J, Wheeler B, Feuer EJ. Twenty years since Joinpoint 1.0: two major enhancements, their justification, and impact. Stat Med. 2022;41(16):3102\u201330.","journal-title":"Stat Med"},{"issue":"1","key":"670_CR16","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1053\/j.gastro.2020.02.068","volume":"159","author":"M Arnold","year":"2020","unstructured":"Arnold M, Abnet CC, Neale RE, Vignat J, Giovannucci EL, Mcglynn KA, et al. Global burden of 5 major types of gastrointestinal cancer. Gastroenterology. 2020;159(1):335-49.e15.","journal-title":"Gastroenterology"},{"issue":"16","key":"670_CR17","doi-asserted-by":"publisher","first-page":"3029","DOI":"10.1002\/cncr.33587","volume":"127","author":"F Bray","year":"2021","unstructured":"Bray F, Laversanne M, Weiderpass E, Soerjomataram I. The ever-increasing importance of cancer as a leading cause of premature death worldwide. Cancer. 2021;127(16):3029\u201330.","journal-title":"Cancer"},{"issue":"8","key":"670_CR18","doi-asserted-by":"publisher","first-page":"790","DOI":"10.1016\/S1470-2045(12)70211-5","volume":"13","author":"F Bray","year":"2012","unstructured":"Bray F, Jemal A, Grey N, Ferlay J, Forman D. Global cancer transitions according to the human development index (2008\u20132030): a population-based study. Lancet Oncol. 2012;13(8):790\u2013801.","journal-title":"Lancet Oncol"},{"issue":"3","key":"670_CR19","doi-asserted-by":"publisher","first-page":"e137","DOI":"10.1016\/S2468-2667(18)30267-6","volume":"4","author":"H Sung","year":"2019","unstructured":"Sung H, Siegel RL, Rosenberg PS, Jemal A. Emerging cancer trends among young adults in the USA: analysis of a population-based cancer registry. Lancet Public Health. 2019;4(3):e137\u201347.","journal-title":"Lancet Public Health"},{"issue":"6","key":"670_CR20","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1038\/s41575-019-0253-4","volume":"17","author":"LJ Hofseth","year":"2020","unstructured":"Hofseth LJ, Hebert JR, Chanda A, Chen H, Love BL, Pena MM, et al. Early-onset colorectal cancer: initial clues and current views. Nat Rev Gastroenterol Hepatol. 2020;17(6):352\u201364.","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"1","key":"670_CR21","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/j.1753-4887.2011.00456.x","volume":"70","author":"BM Popkin","year":"2012","unstructured":"Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev. 2012;70(1):3\u201321.","journal-title":"Nutr Rev"},{"issue":"11","key":"670_CR22","doi-asserted-by":"publisher","first-page":"1909","DOI":"10.1017\/S0007114515003657","volume":"114","author":"F Naja","year":"2015","unstructured":"Naja F, Hwalla N, Itani L, Karam S, Sibai AM, Nasreddine L. A western dietary pattern is associated with overweight and obesity in a national sample of Lebanese adolescents (13\u201319 years): a cross-sectional study. Br J Nutr. 2015;114(11):1909\u201319.","journal-title":"Br J Nutr"},{"issue":"15","key":"670_CR23","doi-asserted-by":"publisher","first-page":"1419","DOI":"10.1056\/NEJMoa1610187","volume":"376","author":"EJ Mayer-Davis","year":"2017","unstructured":"Mayer-Davis EJ, Lawrence JM, Dabelea D, Divers J, Isom S, Dolan L, et al. Incidence trends of type 1 and type 2 diabetes among youths, 2002\u20132012. N Engl J Med. 2017;376(15):1419\u201329.","journal-title":"N Engl J Med"},{"issue":"10113","key":"670_CR24","doi-asserted-by":"publisher","first-page":"2627","DOI":"10.1016\/S0140-6736(17)32129-3","volume":"390","author":"Ncd Risk Factor Collaboration (Ncd-Risc)","year":"2017","unstructured":"Ncd Risk Factor Collaboration (Ncd-Risc). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128\u00b79 million children, adolescents, and adults. Lancet. 2017;390(10113):2627\u201342.","journal-title":"Lancet"},{"issue":"11","key":"670_CR25","doi-asserted-by":"publisher","first-page":"1541","DOI":"10.1089\/thy.2016.0100","volume":"26","author":"JJ Wiltshire","year":"2016","unstructured":"Wiltshire JJ, Drake TM, Uttley L, Balasubramanian SP. Systematic review of trends in the incidence rates of thyroid cancer. Thyroid. 2016;26(11):1541\u201352.","journal-title":"Thyroid"},{"issue":"1","key":"670_CR26","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1530\/ERC-17-0397","volume":"25","author":"L Furuya-Kanamori","year":"2018","unstructured":"Furuya-Kanamori L, Sedrakyan A, Onitilo AA, Bagheri N, Glasziou P, Doi SaR. Differentiated thyroid cancer: millions spent with no tangible gain?. Endocr Relat Cancer. 2018;25(1):51\u20137.","journal-title":"Endocr Relat Cancer"},{"issue":"12","key":"670_CR27","doi-asserted-by":"publisher","first-page":"2179","DOI":"10.1136\/gutjnl-2019-319511","volume":"68","author":"RL Siegel","year":"2019","unstructured":"Siegel RL, Torre LA, Soerjomataram I, Hayes RB, Bray F, Weber TK, et al. Global patterns and trends in colorectal cancer incidence in young adults. Gut. 2019;68(12):2179\u201385.","journal-title":"Gut"},{"issue":"10","key":"670_CR28","doi-asserted-by":"publisher","first-page":"1820","DOI":"10.1136\/gutjnl-2018-317592","volume":"68","author":"FE Vuik","year":"2019","unstructured":"Vuik FE, Nieuwenburg SA, Bardou M, Lansdorp-Vogelaar I, Dinis-Ribeiro M, Bento MJ, et al. Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years. Gut. 2019;68(10):1820\u20136.","journal-title":"Gut"},{"issue":"3","key":"670_CR29","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1016\/S2468-1253(21)00426-X","volume":"7","author":"SG Patel","year":"2022","unstructured":"Patel SG, Karlitz JJ, Yen T, Lieu CH, Boland CR. The rising tide of early-onset colorectal cancer: a comprehensive review of epidemiology, clinical features, biology, risk factors, prevention, and early detection. Lancet Gastroenterol Hepatol. 2022;7(3):262\u201374.","journal-title":"Lancet Gastroenterol Hepatol"},{"issue":"4","key":"670_CR30","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1038\/s41571-020-00445-1","volume":"18","author":"N Akimoto","year":"2021","unstructured":"Akimoto N, Ugai T, Zhong R, Hamada T, Fujiyoshi K, Giannakis M, et al. Rising incidence of early-onset colorectal cancer: a call to action. Nat Rev Clin Oncol. 2021;18(4):230\u201343.","journal-title":"Nat Rev Clin Oncol"},{"issue":"4","key":"670_CR31","doi-asserted-by":"publisher","DOI":"10.1093\/jncics\/pkae052","volume":"8","author":"J Chen","year":"2024","unstructured":"Chen J, Yang W. Comparing cohort and period trends of early-onset colorectal cancer: a global analysis. JNCI Cancer Spectr. 2024;8(4):pkae052.","journal-title":"JNCI Cancer Spectr"},{"issue":"2","key":"670_CR32","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1136\/gutjnl-2022-327736","volume":"72","author":"E Morgan","year":"2023","unstructured":"Morgan E, Arnold M, Gini A, Lorenzoni V, Cabasag CJ, Laversanne M, et al. Global burden of colorectal cancer in 2020 and 2040: incidence and mortality estimates from GLOBOCAN. Gut. 2023;72(2):338\u201344.","journal-title":"Gut"},{"issue":"1","key":"670_CR33","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1001\/jamasurg.2014.1756","volume":"150","author":"CE Bailey","year":"2015","unstructured":"Bailey CE, Hu CY, You YN, Bednarski BK, Rodriguez-Bigas MA, Skibber JM, et al. Increasing disparities in the age-related incidences of colon and rectal cancers in the United States, 1975\u20132010. JAMA Surg. 2015;150(1):17\u201322.","journal-title":"JAMA Surg"},{"issue":"2","key":"670_CR34","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1038\/s41591-020-01210-8","volume":"27","author":"LS Flor","year":"2021","unstructured":"Flor LS, Reitsma MB, Gupta V, Ng M, Gakidou E. The effects of tobacco control policies on global smoking prevalence. Nat Med. 2021;27(2):239\u201343.","journal-title":"Nat Med"},{"issue":"5","key":"670_CR35","first-page":"321","volume":"70","author":"ETH Fontham","year":"2020","unstructured":"Fontham ETH, Wolf AMD, Church TR, Etzioni R, Flowers CR, Herzig A, et al. Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society. CA Cancer J Clin. 2020;70(5):321\u201346.","journal-title":"CA Cancer J Clin"},{"issue":"14","key":"670_CR36","doi-asserted-by":"publisher","first-page":"1340","DOI":"10.1056\/NEJMoa1917338","volume":"383","author":"J Lei","year":"2020","unstructured":"Lei J, Ploner A, Elfstr\u00f6m KM, Wang J, Roth A, Fang F, et al. HPV vaccination and the risk of invasive cervical cancer. N Engl J Med. 2020;383(14):1340\u20138.","journal-title":"N Engl J Med"},{"issue":"10381","key":"670_CR37","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1016\/S0140-6736(22)01468-4","volume":"401","author":"WJ Jeng","year":"2023","unstructured":"Jeng WJ, Papatheodoridis GV, Lok ASF. Hepatitis B. Lancet. 2023;401(10381):1039\u201352.","journal-title":"Lancet"},{"issue":"9","key":"670_CR38","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1016\/S2468-1253(22)00124-8","volume":"7","author":"GBD 2019 Hepatitis B Collaborators","year":"2022","unstructured":"GBD 2019 Hepatitis B Collaborators. Global, regional, and national burden of hepatitis B, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Gastroenterol Hepatol. 2022;7(9):796\u2013829.","journal-title":"Lancet Gastroenterol Hepatol"}],"container-title":["Military Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40779-025-00670-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40779-025-00670-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40779-025-00670-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T20:53:13Z","timestamp":1772830393000},"score":1,"resource":{"primary":{"URL":"https:\/\/mmrjournal.biomedcentral.com\/articles\/10.1186\/s40779-025-00670-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,14]]},"references-count":38,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["670"],"URL":"https:\/\/doi.org\/10.1186\/s40779-025-00670-8","relation":{},"ISSN":["2054-9369"],"issn-type":[{"value":"2054-9369","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,14]]},"assertion":[{"value":"15 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no potential competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"79"}}